Patient Characteristics and feto-maternal Outcomes Among Cases Of Placenta Previa and Accidental Hemorrhage

Introduction: Third trimester bleeding is one of the majorobstetric emergencies, which contribute greatly to maternaland fetal morbidity and mortality. It is defined as bleeding from or into the genital tract prior to delivery of thebaby anytime from 20 weeks gestation, in some developedcountries or 24 weeks gestation, in others or 28 weeks incountries with low resource settings thus lacking adequateneonatal support incubators.The aim of this study: The study aimed to elucidate theoutcomes with the associated morbidities, which will help define the magnitude of the problem posed by antepartumhemorrhage in order to better the management measuresavailable to promptly tackle and alleviate this condition.Patients & Methods: This study was prospective observational study conducted in Department of Obstetrics andGynecology, Faculty of Medicine, Fayoum UniversityHospital and El-Sahel Teaching Hospital. All cases of antepartum hemorrhage admitted to emergency unit at maternity hospital after the age of 28 week of gestation during theperiod from (1st of August 2019 to end of November 2020)were included in this study, meeting the inclusion and exclusion criterion.Results: Total number of patients who were admitted toobstetric department with APH during the study period was120 case of them 25 cases were elective and all of themwere placenta previa cases and 95 cases were emergency.67 cases (55.83%) with placenta previa (25 elective and 42emergency) & 44 (36.636%) with accidental hemorrhage(all are emergency or urgent cases), 9 (7.5%) due to othercauses. Maternal outcome in PP include Increased numbersof CS 67 case (100%), Increased number of units of bloodtransfusion (1-18) unit with mean 4.31 ± 3.27, Hysterectomy 21 case (31.3 %), Shock 29 case (43.3 %), Urinary injury either bladder or ureteric injury 5 cases (7.5 %) (4cases bladder injury and 1 case Ureteric injury) all of themwere placenta percreta, ICU admission 14 case (20.9 %),postpartum hemorrhage occurred in 6 cases and maternalmortality one case (1.5%). While maternal out come in accidental hemorrhage patients was numbers of CS delivery was 35 cases and 9 cases delivered vaginally,number of units of blood transfusion (1-18)unit with mean 3.57 ± 3.08, Hysterectomy 3cases (6.8%), Shock 22 case (50%),Conclusion Previous CS was found to be the mostimportant risk factor for Placenta praeviaand accreta Pre-eclampsia& previous abruption were the most important risk factors forabruption. Fetal morbidities associated withboth placenta previa & abruption were prematurity, low birth weight, low Apgar score,admission to NICU.